System and method for registration between coordinate systems and navigation

ABSTRACT

Disclosed is a system for assisting in guiding and performing a procedure on a subject. The subject may be any appropriate subject such as inanimate object and/or an animate object. The guide and system may include various manipulable or movable members, such as robotic systems, and may be registered to selected coordinate systems.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.16/244,330, filed on Jan. 10, 2019. This application includes subjectmatter similar to that disclosed U.S. Patent Publication No.2020-0222122-A1. The entire disclosure of the above applications areincorporated herein by reference.

FIELD

The subject disclosure is related generally to a tracking and navigationsystem, and particularly to registering coordinate systems.

BACKGROUND

This section provides background information related to the presentdisclosure which is not necessarily prior art.

An instrument can be navigated relative to a subject for performingvarious procedures. For example, the subject can include a patient onwhich a surgical procedure is being performed. During a surgicalprocedure, an instrument can be tracked in an object or subject space.In various embodiments the subject space can be a patient space definedby a patient. The location of the instrument that is tracked can bedisplayed on a display device relative to an image of the patient.

The position of the patient can be determined with a tracking system.Generally, a patient is registered to the image, via tracking aninstrument relative to the patient to generate a translation map betweenthe subject or object space (e.g. patient space) and the image space.This often requires time during a surgical procedure for a user, such asa surgeon, to identify one or more points in the subject space andcorrelating, often identical points, in the image space.

After registration, the position of the instrument can be appropriatelydisplayed on the display device while tracking the instrument. Theposition of the instrument relative to the subject can be displayed as agraphical representation, sometimes referred to as an icon on thedisplay device.

SUMMARY

This section provides a general summary of the disclosure, and is not acomprehensive disclosure of its full scope or all of its features.

According to various embodiments, a fiducial object can be imaged withan imaging system. The fiducial object may be connected to a selectedsystem, such as a robotic system. The robotic system may include anappropriate robotic system, such as a Mazor X™ Robotic Guidance System,sold by Mazor Robotics Ltd. having a place of business in Israel and/orMedtronic, Inc. having a place of business in Minnesota, USA. Thefiducial object may include one or more objects, such as an array ofdiscrete objects. The discrete objects may include spheres, objects ofvarious shapes, a continuous and/or one or more rods that can all be inone or intersect one plane. The fiducial object can be modeled inthree-dimensional (3D) space as a 3D model. Fiducial features can beextracted from the 3D model. The fiducial features can be compared to orcoordinated with image fiducial features that are the imaged fiducialobject or some portion thereof (e.g. an image fiducial feature can be apoint relating to a center of a sphere or a circle or point relating toan intersection of a rod with a plane).

In various embodiments, the different systems used relative to thesubject may include different coordinate systems (e.g. locatingsystems). For example, a robotic system may be moved relative to asubject that includes a robotic coordinate system. The robot may befixed, including removably fixed, at a position relative to the subject.Thus, movement of a portion of the robot relative to the base of therobot (i.e. the fixed portion of the robot) may be known due to variousfeatures of the robot. For example, encoders (e.g. optical encoders,potentiometer encoders, or the like) may be used to determine movementor amount of movement of various joints (e.g. pivots) of a robot. Aposition of an end effector (e.g. a terminal end) of the robot may beknown relative to the base of the robot. Given a known position of thesubject relative to the base and the immovable relative position of thebase and the subject, the position of the end effector relative to thesubject may be known during movement of a robot and/or during astationary period of the end effector. Thus, the robot may define acoordinate system relative to the subject.

Various other portions may also be tracked relative to the subject. Forexample, a tracking system may be incorporated into a navigation systemthat includes one or more instruments that may be tracked relative tothe subject. The navigation system may include one or more trackingsystems that track various portions, such as tracking devices,associated with instruments. The tracking system may include a localizerthat is configured to determine the position of the tracking device in anavigation system coordinate system. Determination of the navigationsystem coordinate system may include those described at variousreferences including U.S. Pat. Nos. 8,737,708; 9,737,235; 8,503,745; and8,175,681; all incorporated herein by reference. In particular, alocalizer may be able to track an object within a volume relative to thesubject. The navigation volume, in which a device, may be tracked mayinclude or be referred to as the navigation coordinate system ornavigation space. A determination or correlation between the twocoordinate systems may allow for or also be referred to as aregistration between two coordinate systems.

In various embodiments the first coordinate system, which may be arobotic coordinate system, may be registered to a second coordinatesystem, which may be a navigation coordinate system. Accordingly,coordinates in one coordinate system may then be transformed to adifferent or second coordinate system due to a registration.Registration may allow for the use of two coordinate systems and/or theswitching between two coordinate systems. For example, during aprocedure a first coordinate system may be used for a first portion or aselected portion of a procedure and a second coordinate system may beused during a second portion of a procedure. Further, two coordinatesystems may be used to perform or track a single portion of a procedure,such as for verification and/or collection of additional information.

Furthermore, images may be acquired of selected portions of a subject.The images may be displayed for viewing by a user, such as a surgeon.The images may have superimposed on a portion of the image a graphicalrepresentation of a tracked portion or member, such as an instrument.According to various embodiments, the graphical representation may besuperimposed on the image at an appropriate position due to registrationof an image space (also referred to as an image coordinate system) to asubject space. A method to register a subject space defined by a subjectto an image space may include those disclosed in U.S. Pat. Nos.8,737,708; 9,737,235; 8,503,745; and 8,175,681; all incorporated hereinby reference.

During a selected procedure, the first coordinate system may beregistered to the subject space or subject coordinate system due to aselected procedure, such as imaging of the subject. In variousembodiments the first coordinate system may be registered to the subjectby imaging the subject with a fiducial portion that is fixed relative tothe first member or system, such as the robotic system. The knownposition of the fiducial relative to the robotic system may be used toregister the subject space relative to the robotic system due to theimage of the subject including the fiducial portion. Thus, the positionof the robotic system or a portion thereof, such as the end effector,may be known or determined relative to the subject. Due to registrationof a second coordinate system to the robotic coordinate system may allowfor tracking of additional elements not fixed to the robot relative to aposition determined or tracked by the robot.

The tracking of an instrument during a procedure, such as a surgical oroperative procedure, allows for navigation of a procedure. When imagedata is used to define an image space it can be correlated or registeredto a physical space defined by a subject, such as a patient. Accordingto various embodiments, therefore, the patient defines a patient spacein which an instrument can be tracked and navigated. The image spacedefined by the image data can be registered to the patient space definedby the patient. The registration can occur with the use of fiducialsthat can be identified in the image data and in the patient space.

Further areas of applicability will become apparent from the descriptionprovided herein. The description and specific examples in this summaryare intended for purposes of illustration only and are not intended tolimit the scope of the present disclosure.

DRAWINGS

The drawings described herein are for illustrative purposes only ofselected embodiments and not all possible implementations, and are notintended to limit the scope of the present disclosure.

FIG. 1 is diagrammatic view illustrating an overview of a robotic systemand a navigation system, according to various embodiments;

FIG. 2 is a detailed environmental view of a robotic system and atracking system, according to various embodiments;

FIG. 3 is a detailed view of a robotic system with a snapshot trackingdevice, according to various embodiments;

FIG. 4 is a flow chart of a method of registering a robotic space to animage space;

FIG. 5 is a flow chart of an image space to patient space registration;

FIG. 6 is a flow chart of a robotic coordinate system to a navigationcoordinate system registration;

FIG. 7 is a flow chart of a method of recalling a registration forfurther procedure portions, according to various embodiments;

FIG. 8 is a flow chart of a method of registering a navigation space toan image space with an intermediate registration; and

FIG. 9 is an environmental view of a dynamic reference tracking device.

Corresponding reference numerals indicate corresponding parts throughoutthe several views of the drawings.

DETAILED DESCRIPTION

Example embodiments will now be described more fully with reference tothe accompanying drawings.

The subject disclosure is directed to an exemplary embodiment of asurgical procedure on a subject, such as a human patient. It isunderstood, however, that the system and methods described herein aremerely exemplary and not intended to limit the scope of the claimsincluded herein. In various embodiments, it is understood, that thesystems and methods may be incorporated into and/or used on non-animateobjects. The systems may be used to, for example, to register coordinatesystems between two systems for use on manufacturing systems,maintenance systems, and the like. For example, automotive assembly mayuse one or more robotic systems including individual coordinate systemsthat may be registered together for coordinated or consorted actions.Accordingly, the exemplary illustration of a surgical procedure hereinis not intended to limit the scope of the appended claims.

Discussed herein, according various embodiments, are processes andsystems for allowing registration between various coordinate systems. Invarious embodiments, a robotic or first coordinate system may beregistered to an image coordinate system or space. A navigation space orcoordinate system may then be registered to the robotic or firstcoordinate system and, therefore, be registered to the image coordinatesystem without being separately or independently registered to the imagespace. Similarly, the navigation space or coordinate system may beregistered to the image coordinate system or space directly orindependently. The robotic or first coordinate system may then beregistered to the navigation space and, therefore, be registered to theimage coordinate system or space without being separately orindependently registered to the image space.

FIG. 1 is a diagrammatic view illustrating an overview of a procedureroom or arena. In various embodiments, the procedure room may include asurgical suite in which may be placed a robotic system 20 and anavigation system 26 that can be used for various procedures. Therobotic system 20 may include a Mazor X™ robotic guidance system, soldby Medtronic, Inc. The robotic system 20 may be used to assist inguiding selected instrument, such as drills, screws, etc. relative to asubject 30. The robotic system 20 may include a mount 34 that fixes aportion, such as a robotic base 38, relative to the subject 30. Therobotic system 20 may include one or more arms 40 that are moveable orpivotable relative to the subject 30, such as including an end effector44. The end effector may be any appropriate portion, such as a tube,guide, or passage member. The end effector 44 may be moved relative tothe base 38 with one or more motors. The position of the end effector 44may be known or determined relative to the base 38 with one or moreencoders at one or more joints, such as a wrist joint 48 and/or an elbowjoint 52 of the robotic system 20.

The navigation system 26 can be used to track the location of one ormore tracking devices, tracking devices may include a robot trackingdevice 54, a subject tracking device 58, an imaging system trackingdevice 62, and/or an tool tracking device 66. A tool 68 may be anyappropriate tool such as a drill, forceps, or other tool operated by auser 72. The tool 68 may also include an implant, such as a spinalimplant or orthopedic implant. It should further be noted that thenavigation system 26 may be used to navigate any type of instrument,implant, or delivery system, including: guide wires, arthroscopicsystems, orthopedic implants, spinal implants, deep brain stimulation(DBS) probes, etc. Moreover, the instruments may be used to navigate ormap any region of the body. The navigation system 26 and the variousinstruments may be used in any appropriate procedure, such as one thatis generally minimally invasive or an open procedure.

An imaging device 80 may be used to acquire pre-, intra-, orpost-operative or real-time image data of a subject, such as the subject30. It will be understood, however, that any appropriate subject can beimaged and any appropriate procedure may be performed relative to thesubject. In the example shown, the imaging device 80 comprises an O-Arm®imaging device sold by Medtronic Navigation, Inc. having a place ofbusiness in Louisville, Colo., USA. The imaging device 80 may have agenerally annular gantry housing 82 in which an image capturing portionis moveably placed. The image capturing portion may include an x-raysource or emission portion and an x-ray receiving or image receivingportion located generally or as practically possible 180 degrees fromeach other and mounted on a rotor relative to a track or rail. The imagecapturing portion can be operable to rotate 360 degrees during imageacquisition. The image capturing portion may rotate around a centralpoint or axis, allowing image data of the subject 80 to be acquired frommultiple directions or in multiple planes. The imaging device 80 caninclude those disclosed in U.S. Pat. Nos. 7,188,998; 7,108,421;7,106,825; 7,001,045; and 6,940,941; all of which are incorporatedherein by reference, or any appropriate portions thereof. In oneexample, the imaging device 80 can utilize flat plate technology havinga 1,720 by 1,024 pixel viewing area.

The position of the imaging device 80, and/or portions therein such asthe image capturing portion, can be precisely known relative to anyother portion of the imaging device 80. The imaging device 80, accordingto various embodiments, can know and recall precise coordinates relativeto a fixed or selected coordinate system. This can allow the imagingsystem 80 to know its position relative to the patient 30 or otherreferences. In addition, as discussed herein, the precise knowledge ofthe position of the image capturing portion can be used in conjunctionwith a tracking system to determine the position of the image capturingportion and the image data relative to the tracked subject, such as thepatient 30.

The imaging device 80 can also be tracked with a tracking device 62. Theimage data defining an image space acquired of the patient 30 can,according to various embodiments, be inherently or automaticallyregistered relative to an object space. The object space can be thespace defined by a patient 30 in the navigation system 26. The automaticregistration can be achieved by including the tracking device 62 on theimaging device 80 and/or the determinable precise location of the imagecapturing portion. According to various embodiments, as discussedherein, imagable portions, virtual fiducial points and other featurescan also be used to allow for registration, automatic or otherwise. Itwill be understood, however, that image data can be acquired of anysubject which will define subject space. Patient space is an exemplarysubject space. Registration allows for a translation between patientspace and image space.

The patient 80 can also be tracked as the patient moves with a patienttracking device, DRF, or tracker 58. Alternatively, or in additionthereto, the patient 30 may be fixed within navigation space defined bythe navigation system 26 to allow for registration. As discussed furtherherein, registration of the image space to the patient space or subjectspace allows for navigation of the instrument 68 with the image data.When navigating the instrument 68, a position of the instrument 68 canbe illustrated relative to image data acquired of the patient 30 on adisplay device 84. Various tracking systems, such as one including anoptical localizer 88 or an electromagnetic (EM) localizer 92 can be usedto track the instrument 68.

More than one tracking system can be used to track the instrument 68 inthe navigation system 26. According to various embodiments, these caninclude an electromagnetic tracking (EM) system having the EM localizer94 and/or an optical tracking system having the optical localizer 88.Either or both of the tracking systems can be used to tracked selectedtracking devices, as discussed herein. It will be understood, unlessdiscussed otherwise, that a tracking device can be a portion trackablewith a selected tracking system. A tracking device need not refer to theentire member or structure to which the tracking device is affixed orassociated.

It is further appreciated that the imaging device 80 may be an imagingdevice other than the O-Arm® imaging device and may include in additionor alternatively a fluoroscopic C-arm. Other exemplary imaging devicesmay include fluoroscopes such as bi-plane fluoroscopic systems, ceilingmounted fluoroscopic systems, cath-lab fluoroscopic systems, fixed C-armfluoroscopic systems, isocentric C-arm fluoroscopic systems, 3Dfluoroscopic systems, etc. Other appropriate imaging devices can alsoinclude MRI, CT, ultrasound, etc.

In various embodiments, an imaging device controller 96 may control theimaging device 80 and can receive the image data generated at the imagecapturing portion and store the images for later use. The controller 96can also control the rotation of the image capturing portion of theimaging device 80. It will be understood that the controller 96 need notbe integral with the gantry housing 82, but may be separate therefrom.For example, the controller may be a portions of the navigation system26 that may include a processing and/or control system 98 including aprocessing unit or processing portion 102. The controller 96, however,may be integral with the gantry 82 and may include a second and separateprocessor, such as that in a portable computer.

The patient 30 can be fixed onto an operating table 104. According toone example, the table 104 can be an Axis Jackson® operating table soldby OSI, a subsidiary of Mizuho Ikakogyo Co., Ltd., having a place ofbusiness in Tokyo, Japan or Mizuho Orthopedic Systems, Inc. having aplace of business in California, USA. Patient positioning devices can beused with the table, and include a Mayfield® clamp or those set forth incommonly assigned U.S. patent application Ser. No. 10/405,068 entitled“An Integrated Electromagnetic Navigation And Patient PositioningDevice”, filed Apr. 1, 2003 which is hereby incorporated by reference.

The position of the patient 30 relative to the imaging device 80 can bedetermined by the navigation system 26. The tracking device 62 can beused to track and locate at least a portion of the imaging device 80,for example the gantry or housing 82. The patient 30 can be tracked withthe dynamic reference frame 58, as discussed further herein.Accordingly, the position of the patient 30 relative to the imagingdevice 80 can be determined. Further, the location of the imagingportion can be determined relative to the housing 82 due to its preciseposition on the rail within the housing 82, substantially inflexiblerotor, etc. The imaging device 80 can include an accuracy of within 10microns, for example, if the imaging device 80 is an O-Arm® imagingdevice sold by Medtronic Navigation, Inc. having a place of business inLouisville, Colo. Precise positioning of the imaging portion is furtherdescribed in U.S. Pat. Nos. 7,188,998; 7,108,421; 7,106,825; 7,001,045;and 6,940,941; all of which are incorporated herein by reference,

According to various embodiments, the imaging device 80 can generateand/or emit x-rays from the x-ray source that propagate through thepatient 30 and are received by the x-ray imaging receiving portion. Theimage capturing portion generates image data representing theintensities of the received x-rays. Typically, the image capturingportion can include an image intensifier that first converts the x-raysto visible light and a camera (e.g. a charge couple device) thatconverts the visible light into digital image data. The image capturingportion may also be a digital device that converts x-rays directly todigital image data for forming images, thus potentially avoidingdistortion introduced by first converting to visible light.

Two dimensional and/or three dimensional fluoroscopic image data thatmay be taken by the imaging device 80 can be captured and stored in theimaging device controller 96. Multiple image data taken by the imagingdevice 80 may also be captured and assembled to provide a larger view orimage of a whole region of a patient 30, as opposed to being directed toonly a portion of a region of the patient 30. For example, multipleimage data of the patient's 30 spine may be appended together to providea full view or complete set of image data of the spine.

The image data can then be forwarded from the image device controller 96to the navigation computer and/or processor system 102 that can be apart of a controller or work station 98 having the display 84 and a userinterface 106. It will also be understood that the image data is notnecessarily first retained in the controller 96, but may also bedirectly transmitted to the work station 98. The work station 98 canprovide facilities for displaying the image data as an image 108 on thedisplay 84, saving, digitally manipulating, or printing a hard copyimage of the received image data. The user interface 106, which may be akeyboard, mouse, touch pen, touch screen or other suitable device,allows the user 72 to provide inputs to control the imaging device 80,via the image device controller 96, or adjust the display settings ofthe display 84. The work station 98 may also direct the image devicecontroller 96 to adjust the image capturing portion of the imagingdevice 80 to obtain various two-dimensional images along differentplanes in order to generate representative two-dimensional andthree-dimensional image data.

With continuing reference to FIG. 1 , the navigation system 26 canfurther include the tracking system including either or both of theelectromagnetic (EM) localizer 94 and/or the optical localizer 88. Thetracking systems may include a controller and interface portion 110. Thecontroller 110 can be connected to the processor portion 102, which caninclude a processor included within a computer. The EM tracking systemmay include the STEALTHSTATION® AXIEM™ Navigation System, sold byMedtronic Navigation, Inc. having a place of business in Louisville,Colo.; or can be the EM tracking system described in U.S. patentapplication Ser. No. 10/941,782, filed Sep. 15, 2004, and entitled“METHOD AND APPARATUS FOR SURGICAL NAVIGATION”; U.S. Pat. No. 5,913,820,entitled “Position Location System,” issued Jun. 22, 1999; and U.S. Pat.No. 5,592,939, entitled “Method and System for Navigating a CatheterProbe,” issued Jan. 14, 1997; all of which are herein incorporated byreference. It will be understood that the navigation system 26 may alsobe or include any appropriate tracking system, including aSTEALTHSTATION® TREON® or S7™ tracking systems having an opticallocalizer, that may be used as the optical localizer 88, and sold byMedtronic Navigation, Inc. of Louisville, Colo. Other tracking systemsinclude an acoustic, radiation, radar, etc. The tracking systems can beused according to generally known or described techniques in the aboveincorporated references. Details will not be included herein except whento clarify selected operation of the subject disclosure.

Wired or physical connections can interconnect the tracking systems,imaging device 80, etc. Alternatively, various portions, such as theinstrument 68 may employ a wireless communications channel, such as thatdisclosed in U.S. Pat. No. 6,474,341, entitled “Surgical CommunicationPower System,” issued Nov. 5, 2002, herein incorporated by reference, asopposed to being coupled directly to the controller 110. Also, thetracking devices 62, 66, 54 can generate a field and/or signal that issensed by the localizer(s) 88, 94.

Various portions of the navigation system 26, such as the instrument 68,and others as will be described in detail below, can be equipped with atleast one, and generally multiple, of the tracking devices 66. Theinstrument can also include more than one type or modality of trackingdevice 66, such as an EM tracking device and/or an optical trackingdevice. The instrument 68 can include a graspable or manipulable portionat a proximal end and the tracking devices may be fixed near themanipulable portion of the instrument 68.

Additional representative or alternative localization and trackingsystem is set forth in U.S. Pat. No. 5,983,126, entitled “CatheterLocation System and Method,” issued Nov. 9, 1999, which is herebyincorporated by reference. The navigation system 26 may be a hybridsystem that includes components from various tracking systems.

According to various embodiments, the navigation system 26 can be usedto track the instrument 68 relative to the patient 30. The instrument 68can be tracked with the tracking system, as discussed above. Image dataof the patient 30, or an appropriate subject, can be used to assist theuser 72 in guiding the instrument 68. The image data, however, isregistered to the patient 30. The image data defines an image space thatis registered to the patient space defined by the patient 30. Theregistration can be performed as discussed herein, automatically,manually, or combinations thereof.

Generally, registration allows a translation map to be generated of thephysical location of the instrument 68 relative to the image space ofthe image data. The translation map allows the tracked position of theinstrument 68 to be displayed on the display device 84 relative to theimage data 108. A graphical representation 68 i, also referred to as anicon, can be used to illustrate the location of the instrument 68relative to the image data 108.

With continuing reference to FIG. 1 and additional reference to FIG. 2and FIG. 3 , a subject registration system or method can use thetracking device 58. The tracking device 58 may include portions ormembers 120 that may be trackable, but may also act as or be operable asa fiducial assembly. The fiducial assembly 120 can include a clamp orother fixation portion 124 and the imagable fiducial body 120. It isunderstood, however, that the members 120 may be separate from thetracking device 58. The fixation portion 124 can be provided to fix anyappropriate portion, such as a portion of the anatomy. As illustrated inFIGS. 1 and 2 , the fiducial assembly 120 can be interconnected with aportion of a spine 126 such as a spinous process 130.

The fixation portion 124 can be interconnected with a spinous process130 in any appropriate manner. For example, a pin or a screw can bedriven into the spinous process 130. Alternatively, or in additionthereto, a clamp portion 124 can be provided to interconnect the spinousprocess 130. The fiducial portions 120 may be imaged with the imagingdevice 80. It is understood, however, that various portions of thesubject (such as a spinous process) may also be used as a fiducialportion.

In various embodiments, when the fiducial portions 120 are imaged withthe imaging device 80, image data is generated that includes oridentifies the fiducial portions 120. The fiducial portions 120 can beidentified in image data automatically (e.g. with a processor executinga program), manually (e.g. by selection an identification by the user72), or combinations thereof (e.g. by selection an identification by theuser 72 of a seed point and segmentation by a processor executing aprogram). Methods of automatic imagable portion identification includethose disclosed in U.S. Pat. No. 8,150,494 issued on Apr. 3, 2012,incorporated herein by reference. Manual identification can includeselecting an element (e.g. pixel) or region in the image data whereinthe imagable portion has been imaged. Regardless, the fiducial portions120 identified in the image data can be used as fiducial points orpositions that can be used to register the image data or the image spaceof the image data with patient space.

In various embodiments, to register an image space or coordinate systemto another space or coordinate system, such as a navigation space, thefiducial portions 120 that are identified in the image 108 may then beidentified in the subject space defined by the subject 30, in anappropriate manner. For example, the user 72 may move the instrument 68relative to the subject 30 to touch the fiducial portions 120, if thefiducial portions are attached to the subject 30 in the same positionduring the acquisition of the image data to generate the image 108. Itis understood that the fiducial portions 120, as discussed above invarious embodiments, may be attached to the subject 30 and/or mayinclude anatomical portions of the subject 30. Additionally, a trackingdevice may be incorporated into the fiducial portions 120 and they maybe maintained with the subject 30 after the image is acquired. In thiscase, the registration or the identification of the fiducial portions120 in a subject space may be made. Nevertheless, according to variousembodiments, the user 72 may move the instrument 68 to touch thefiducial portions 120. The tracking system, such as with the opticallocalizer 88, may track the position of the instrument 68 due to thetracking device 66 attached thereto. This allows the user 72 to identifyin the navigation space the locations of the fiducial portions 120 thatare identified in the image 108. After identifying the positions of thefiducial portions 120 in the navigation space, which may include asubject space, the translation map may be made between the subject spacedefined by the subject 30 in a navigation space and the image spacedefined by the image 108. Accordingly, identical or known locationsallow for registration as discussed further herein.

During registration, a translation map is determined between the imagedata coordinate system of the image data such as the image 108 and thepatient space defined by the patient 30. Once the registration occurs,the instrument 68 can be tracked with the tracking system that isregistered to the image data to allow an identification and illustrationof a position of the tracked instrument 68 as an icon superimposed onthe image data. Registration of the image 108 (or any selected imagedata) to the subject 30 may occur at any appropriate time.

After the registration of the image space to the patient space, theinstrument 68 can be tracked relative to the image 108. As illustratedin FIG. 1 , the icon 68 i representing a position (which may include a 6degree of freedom position (including 3D location and orientation)) ofthe instrument 68 can be displayed relative to the image 108 on thedisplay 84. Due to the registration of the image space to the patientspace, the position of the icon 68 i relative to the image 108 cansubstantially identify or mimic the location of the instrument 68relative to the patient 30 in the patient space. As discussed above,this can allow a navigated procedure to occur.

The robotic system 20 having the robotic system coordinate system may beregistered to the navigation space coordinate system, as discussedherein, due to the reference tracking device 54 (e.g. if fixed to aknown position on or relative to the robotic system 20) and/or due tothe tracking of the snapshot tracking device 160. The snapshot trackingdevice 160 may include one or more trackable portions 164 that may betracked with the localizer 88 or any appropriate localizer (e.g.optical, EM, radar). It is understood, however, that any appropriatetracking system may be used to track the snapshot tracking device 160. Afixed reference tracking device may also be positioned within thenavigation space. The fixed navigation tracker may include the patienttracker 58 which may be connected to the patient 30 and/or the robottracker 54 that may be fixed to the base 34 of the robotic system 20.The reference tracker, therefore, may be any appropriate tracker that ispositioned relative to the snapshot tracker 160 that is within thenavigation coordinate space during the registration period. For thediscussion herein the robot tracker 54 will be referred to however, thepatient tracker 58 may also be used as the reference tracker. Further,reference tracker may be positioned within the coordinate system at anyposition relative to the snapshot tracker 160 as long as the snapshottracker 160 may be tracked relative to the reference tracker.

In various embodiments, the snapshot tracker 160 may be positioned at aknown position relative to the end effector 44. For example, thesnapshot tracker 160, as illustrated in FIG. 3 , which includes thetrackable portions 164, extends from a rod or connection member 168. Theconnection member 168 may include a keyed portion, such as a projection172 that may engage a slot 174 of the end effector 44. The end effector44 may form or define a cannula or passage 176 that may engage theconnector 168. The connector 168 may be positioned within the passage176 of the end effector 44. The connector 168 may then be fixed to theend effector 44, such as with a fixation member including a set screw orclamping of the end effector 44, such as with a set screw or clampingmember 180. The projection 172 may engage within the slot 174 to fix thesnapshot tracker 160 rotationally relative to the end effector 44. Theconnector 168 positioned within the passage 176 and locked in place withthe set screw 180 may then rigidly fix the snapshot tracking device 160relative to the end effector 44. Thus, the position of the snapshottracker 160 relative to the end effector 44 may be fixed.

The localizer 88 may then view or determine a position of the snapshottracking device 160 relative to the reference tracking device 54 and orthe reference tracking device 58. As the localizer 88 defines or may beused to define the navigation space, determining or tracking a positionof the snapshot localizer 160 relative to the reference frame 54 may beused to determine a relationship between a position within thenavigation space and the robotic space of the end effector 44.

With continuing reference to FIG. 3 , therefore, the navigation spacedefined by the localizer 88 may include the full navigation space 170which may include portions relative to the subject, such as the subjecttracker 58 and other portions that may be moved therein, such as theinstrument 68. The robotic registration space may be smaller and mayinclude a robotic registration space 174 that may include the referenceframe 54 and the snapshot tracker 160. As discussed above, however, therobot registration navigation space may include the snapshot tracker 160and the patient tracker 58 for registration. Accordingly, the exemplaryregistration navigation space 174 is merely for the current discussion.As discussed herein, both the robotic reference tracker 54 and thepatient tracker 58 need not be used simultaneously. This is particularlytrue when the patient 30 is fixed in space, such as fixed relative tothe robotic system 20.

With continuing reference to FIG. 2 and FIG. 3 , and additionalreference to FIGS. 4-8 , a process or method of coordinating orregistering a robotic coordinate system of the robotic system 20 to anavigation space or navigation coordinate system of the navigationsystem 26 is described. The registration may include various portions orsub-parts, as discussed herein. The various parts may occur in anyappropriate order, and the order discussed herein is merely exemplary.The co-registration may further allow only one coordinate system of therobotic or navigation to be registered to a third coordinate system,such as an image coordinate system, but allow the registration of theother to the third coordinate system.

The robotic system 20, as discussed above, is positioned relative to thesubject 30 for various portions of a procedure. In various embodiments,the robotic system 20 may be registered to the subject 30 and to theimage 108 of the subject 30, that may be displayed on the display device84 and/or a second or auxiliary display device 84′ that may be movablerelative to the robotic system 20. The imaging system 80, or anyappropriate imaging system, may be used to image the subject 30. Theimage may include a portion of the subject, such as one or more of thevertebrae 126 and a fiducial or robotic fiducial array 140 that may befixed to the robotic system 20. The robotic fiducial 140 may be fixed toa selected portion of the robotic system 20, such as to the base 34and/or the fixed portion 38. The robotic fiducial 140 may also and/oralternatively be connected to the end effector 44 (illustrated inphantom in FIG. 2 ). The robotic fiducial 140 may be positioned relativeto the subject 30 for acquisition of images such that the fiducial 140is apparent in the images. Upon acquisition of the image of the roboticfiducial 140 and portions of the subject 30, such as the vertebrae 126,the position of the robotic fiducial 140 relative to the vertebrae 126may be determined. If the robotic fiducial 140 is fixed to the roboticsystem 20, the robotic coordinate system may be determined relative tothe subject space coordinate system. In various embodiments, if thefiducial 140 is connected to the end effector 44, the known position ofthe end effector in the robotic coordinate system allows for imageregistration to the robotic coordinate system of the robotic system 20.With continuing reference to FIG. 2 and additional reference to FIG. 4 ,the robotic coordinate system may be registered to a subject space orcoordinate system in the method 182 as described.

Generally, the registration may include positioning the robotic system20 relative to a subject space in block 184. Positioning of the roboticsystem 20 relative to the subject space may include positioning therobotic system 30 relative to the subject, as illustrated in FIG. 2 .Further, positioning of the robotic system 20 may include positioning orremovably positioning the robotic fiducial 140 relative to the subject30. The robotic fiducial 140 may be removably placed in a positionrelative to the robotic system 20 for various procedures and may besubstantially positioned in the same position for different orsubsequent procedures. With the subject 30 positioned relative to therobotic system 20, fiducial images may be acquired of the subject 30 andthe robotic fiducial 140 with the imaging system 80 in block 186. Theacquisition of the fiducial images in block 186 allows for image data tobe acquired of the subject 30, such as with the vertebrae 126, and thefiducial 140.

After acquisition of the robotic fiducial image in block 186,identifying of the robotic fiducial 140 in the acquired fiducial imagesoccurs in block 188. Identification of the robotic fiducial in therobotic fiducial images may be manual, automatic, or a combination ofautomatic and manual. For example, the user may identify the roboticfiducial in the image a selected automatic system may segment thefiducials from the fiducial images, or the user may identify a seedpixel or voxel or multiple seed pixels or voxels and the processorsystem may further segment the fiducial system.

In various embodiments, the acquired images in block 186 may be used forplanning and/or performing a procedure. For example, the imaging system80 may acquire image data sufficient for a selected procedure. Thus, theimages acquired in block 186 may be used for planning and navigating aselected procedure relative to the subject 30. The image data mayinclude two-dimensional image data, reconstructed three-dimensionalimage data, and/or image data acquired over time to illustrate movementof motion of the subject (which may be acquired in 2D or 3D).

In various embodiments, however, the fiducial image acquired in block186 may be optionally registered to other-time or pre-acquired images inblock 190, such as an MRI or a computed tomography scan of the subject30 prior to the acquisition of the fiducial images in block 186. Thepre-acquired images may be acquired at any appropriate time prior to theacquisition of the fiducial images in block 186. It is understood,however, that the images may be acquired after the fiducial images andmay be registered to the fiducial images in a similar manner asdiscussed herein. The registration of the fiducial images to thepre-acquired images may occur in any appropriate manner such assegmentation of selected vertebrae, identification in registration ofselected fiducial elements in the images (e.g. anatomical fiducialportions and/or positioned or implanted fiducial members) or otherappropriate procedures. Generally, the Mazor X® Robotic System maygenerally allow for registration of a pre-acquired image to the fiducialimages and may be appropriate for registering the fiducial images inblock 186 to the pre-acquired images in the registration of thepre-acquired image to the fiducial image in block 190.

The robotic coordinate system may also be registered to the subjectspace in block 192 with the identification of fiducials in the image inblock 188 and the registration. The robotic fiducial 140, imaged withthe fiducial images in block 186, is positioned in a known positionrelative to the robotic system 20, such as the base 34 and/or with theknown position of the end effector 44 in the robotic coordinate system.The robotic coordinate system that is defined by the robotic system 20relative to the base 34 and/or the fixed portion 38 may, therefore also,be pre-determined or known relative to the robotic fiducial 140 as therobotic fiducial 140 is fixed relative to the robotic system 20. Whenposition with the end effector 44, the position of the robotic fiducial140 is known in the robotic coordinate system by tracked (e.g. roboticsystem tracking) movement of the end effector 44. The fiducial imageacquired in block 186 may also assist in defining the patient spacerelative to which the robotic system 20, particularly the end effectormovable portion 44, may move is also then known. As discussed above, theend effector 44 moves in the robotic coordinate system due to therobotic tracking system that may include various mechanisms, such asencoders at the various movable portions, such as the wrist 48 or elbow52, of the robotic system 20. If the fiducial images in block 186 arethe images for performing the procedure, such as for navigation and maythe displayed image 108, the registration may be substantially automaticas the subject 30 may be substantially fixed relative to the roboticsystem 20 (e.g. with a fixation ember extending from the base 38) andconnected to the subject 30, such as the vertebrae 126.

Accordingly the robotic coordinate system can be registered to thesubject space and/or image space according to the method 182. Given theregistration of the robotic coordinate system to the image space therobotic, coordinate system registration may be used to determine aposition of the end effector 44 and/or a member positioned through orwith the end effector 44, relative to the image 108. Accordingly, theimage 108 may be used to display a graphical representation, such as agraphical representation of the member or instrument 45 as an icon 45 isuperimposed or superimposed relative to the image 108.

With reference to FIG. 5 , a flow chart for registration of an imagespace or image coordinate system and a navigation space defined by thelocalizer 88 is illustrated. The method 200 may include varioussub-portions or sub-steps, including those as discussed above. It isunderstood that various sub-steps may occur in any appropriate order,and the order illustrated in FIG. 5 is merely exemplary. Generally atranslation or registration between the image coordinate system and thenavigation coordinate system may occur at any point that the twocoordinate systems may be positioned or determined relative to oneanother.

The method 200 includes an image to patient registration. As discussedabove, the image to patient registration may include acquiring imagedata of a subject, such as the subject 34, with fiducials in block 208.The image data of the subject 34 may be any appropriate image data, suchas image data acquired with the imaging system 80. Further, thefiducials may include the fiducial portions 120, as discussed above,and/or appropriate anatomical portions of the subject 30. For examplethe fiducial portions may include portions of the anatomy such as thespinous process 130 of the subject 30. Nevertheless, the acquired imagedata may include the fiducials therein. Once the image data is acquiredof the subject with the fiducials, identification of the fiducials inthe image space may occur in block 212.

The identification of the fiducials in the image space may occur, asalso discussed above. For example an automatic identification of thefiducials may be made in the image data that defines the image space,such as through automatic segmentation of the fiducial portions withinthe image. Also manual identification and/or combinationmanual-and-automatic identification may be used to determine thefiducials in the image space. The combination may include the user 72identifying one or more pixels as seed pixels and a processor executinga segmentation program based on the seed pixels.

The identification of the fiducials in a subject space and/or navigationspace occurs in block 216. The subject space may be coextensive with thenavigation space and/or may overlap. Generally the navigation space isthe volume that may be tracked with the tracking system, such as thelocalizer 88 and may encompass all or a portion of the subject orpatient 30. The identification of the fiducials in the navigation spacemay occur in various manners such as moving a trackable instrument, suchas the instrument 68, relative to the fiducial portions 120 (which mayalso be a tracking device) and/or the spinous process 130. The trackingsystem of the navigation system 26 may track the instrument 68 and thenavigation system 26 may include an input to input the portions that arethe fiducial portions 120 in the navigation space. The determination oridentification of the position of the fiducials in the navigation spacemay then be used to form a translation map in block 220.

Determination of the translation map determined in block 220 may be acorrelation or registration of the coordinate system of the image spaceto the coordinate system of the navigation space relative to and/orincluding the subject 30. The translation map allows for a determinedposition of a tracked portion in the navigation space to be translatedto an equivalent or identical position in the image. Once the translatedposition is determined, the position may be illustrated or displayedwith the display relative to the image 108, such as by the superimposingof the icon 68 i on or relative to the image 108.

The image to patient registration allows for the illustration of trackedinstruments or items relative to the image 108. Without theregistration, however, any element not trackable or registered to theimage 108 may not be appropriately or precisely illustrated at a realworld position relative to the image 108. In various embodiments,therefore, the robotic coordinate system of the robot system 20 may beregistered to the navigation space. Accordingly, with additionalreference to FIG. 6 , a robotic coordinate system or space to anavigation space registration may occur in method 224. The robotic tonavigation registration may include various portions, as discussedherein.

The robotic system 20 may have a coordinate system that is determinedrelative to the base 34, as discussed above and further herein.Generally the robotic coordinate system may be determined relative tothe subject 30, such as with a fiducial or other appropriate portion.Further the reference tracking device 54 may be used to track ordetermine a location relative to the navigation coordinate system of thenavigation system 26. With reference to FIG. 6 , the robotic coordinatesystem may be registered to the navigation space or navigationcoordinate system according to the process 224.

In the robotic coordinate system to navigation space registration, adetermination of a location of the end effector 44 relative to a basemay be made in block 226. As discussed above, the determination of theposition of the end effector 44 relative to the base 34 may be made inany appropriate manner. For example, various encoders may be positionedat movable joints along the robotic arm 40 of the robotic system 20. Theencoders may include electrical, optical, physical and other appropriateencoders. The encoders may be used to measure and determine a relativeand/or absolute movement or position of the end effector 44 relative tothe base or other appropriate portion of the robotic system 20, such asthe interval portion 38 of the robotic system 20. The robotic system 20may include or be in communication with one or more processors thatreceive signals from the encoders to determine absolute or relativemovement of portions of the robotic system 20. The processor may executeone or more instructions to determine the position of the robotic system20, such as the end effector 44. Accordingly, the location of the endeffector 44 may be determined relative to the robotic system 20 in therobotic coordinate system that may be determined relative to the base 34or other appropriate portion of the robotic system 20.

The registration of the robotic coordinate system to the navigationspace may also include a determination of the location of the base ofthe robotic system as within or defining the robotic coordinate systemin block 228. As discussed above, the robotic coordinate system of therobotic system 20 may be determined relative to an appropriate portion,such as the subject 30, with a selected registration and fiducialportion. The robotic coordinate system, therefore, may be determinedrelative to or of the robotic system 20, such as relative to the base 34or the movable portion 38 of the robotic system 20. Thus, the coordinatesystem of the robotic system may be determined in block 228 beforeregistration to the navigation space that may be determined or basedupon the localizer 88 or other appropriate localizer of the trackingsystem of the navigation system 26.

A connection of a reference device is trackable by the navigation system26 may be made in block 230. As discussed above, the reference device 54may be connected to the robotic system 20, such as to an immovableportion 38 thereof. The reference device 54 is fixed to the roboticsystem 20 at a known position, such as known within the roboticcoordinate system. In various embodiments, the robotic reference 54 maybe fixed at an arbitrary or non-predetermined position relative to therobotic system 20. Thus, the use of the snapshot tracker 160, asdiscussed herein, may be used to determine the position of the roboticreference 54 relative to the snapshot tracker that is moved by the endeffector 44. The tracking system, included with the navigation system26, may be used to track a position substantially fixed in or relativeto the navigation space of the navigation system 26 with the roboticreference 54. It is understood that the reference system or device 54may be connected to any appropriate portion and to the movable portionof the robotic system 20 is merely exemplary.

The robotic to navigation space registration may include tracking thereference frame 54 in the navigation space in block 234. A determinationis then made whether the reference frame 54 is connected at a known orpredetermined position relative to a selected portion of the roboticsystem 20, such as an immovable or removably fixed portion, such as themount 34 or the base arm portion 38. If the robotic reference 54 isfixed at a known or predetermined portion relative to the immovableportion, such as base 38, then tracking the reference 54 with thenavigation system 26 would allow for an automatic determination of therobotic coordinate system relative to the navigation space. For example,the when the robotic reference tracker 54 is tracked (e.g. sensed in thenavigation space) the navigation processor 102 may access the memorysystem to recall the position of the robotic reference 54 in the roboticcoordinate system. The determination of whether the robotic reference isat a known or predetermined position may be made in block 235 and mayinclude a manual input to the navigation system 26, such as with theinput 106, or with other appropriate determinations (e.g. a switch onthe robotic system 20 where the reference frame 54 is connected).

If the determination is yes, a YES path 237 is followed. The Yes path237 may lead to a determination of registration of the roboticcoordinate system to the navigation space in block 238. The registrationis based on the tracked position of the reference device 54. As thereference device 54 has a tracked position, the position is known in thenavigation space. The position of the reference device 54 on the roboticsystem is also known. Because the position on the robotic system 20 isknown of the reference device 54 and the robotic coordinates are knownto the fixed or removable fixed portions (e.g. the base 38), theposition of the reference device 54 in the robotic coordinate system andthe navigation space are known once the reference device 54 is trackedin the navigation space. The position of the reference device 54,therefore, is used as a correlation between the robotic coordinates andthe navigation space to determine a translation map and registration.

If the determination in block 235 is no, a NO path 240 is followed. TheNO path 240 is followed to, in various embodiments, the snapshottracking device 160 may then be connected to movable portion, such asthe end effector 44, of the robotic system 20 in block 241. The snapshottracking device 160 may then be tracked in block 242 in the navigationspace. Thus, the reference tracking device 54 may be tracked in block234 and the snapshot tracking device 160 may be tracked in block 242.The snapshot tracking device 160 may be tracked in a single locationrelative to the reference tracking device 54. The snapshot trackingdevice 160 may have a plurality of samples (e.g. without intentionallymoving the snapshot tracking device 160) of snapshot tracking device 160position made over a selected period of time. If a plurality ofpositions are determined, an average or selected number thereof may beused for the registration when using the snapshot tracking device 160.

Once the snapshot tracking device 160 is tracked in the navigation spacein block 242 and the reference tracking device 54 is tracked in block234, a determination of a correlation between the tracked position ofthe snapshot tracking device and the tracked position of the referencetracking device may be made in block 246. Further, the position of theend effector 44 is known in the robotic coordinate system for eachtracked position in the navigation space, as the end effector ispreviously tracked in the robotic coordinate system (e.g. with theencoders). Based on the two tracked positions, the determinedcorrelation allows for determination of the position of the movableportion of the robotic system 20, including the end effector 44,relative to a reference tracking device in the navigation space. Thecorrelation of the reference tracking device 54 and the snapshottracking device 160 relative to one another may be used to determine theposition of the end effector 44 or other movable portion of the roboticsystem 20 relative to a stationary position in the navigation space(e.g. the space tracked by the localizer 88). Again, the position of thereference device 54 is known in the navigation space due to its beingtracked in the navigation space and fixed on the robotic system 20. Thereference device may be the patient tracker 58 or other appropriatereference device.

With continuing reference to FIG. 5 and FIG. 6 , and additionalreference to FIG. 7 , the robotic system 20 having the roboticcoordinate system, once registered to the navigation space, may also beused to illustrate or represent the position on the image data includedin the image 108. The robotic system 20 may be used to assist the user32 in performing a procedure relative to the subject 30. In variousembodiments, the procedure may include positioning portions relative tothe subject 30, such as relative to one or more vertebrae including thevertebrae 126 of the subject 30. The positioning of the selectedelement, such as a pedicle screw, relative to the vertebrae 126 may beperformed with the robotic system 20. As discussed above, the fiducialportion 140 may be used to register the coordinate system of the roboticsystem 20 relative to the subject 30. Accordingly, the robotic system 20may know or determine a position of the end effector 44 relative to thesubject 30, such as the vertebrae 126 or associated vertebrae, due tothe registration of the robotic system 20 relative to the subject 30.The robotic system 20, as discussed above, includes a selected trackingsystem such as encoders or the like.

Due to the independent nature of the navigation coordinate system andthe robotic coordinate system, the position of the end effector 44 (or amember positioned within and/or through the end effector 44) relative tothe subject 30 may not be known directly in the navigation coordinatesystem based upon the registration of the robotic system 20 relative tothe subject 30. Due to the registration of the robotic system to thenavigation space, as discussed in FIG. 6 , and the registration of theimage space to the navigation/patient space as discussed above in FIG. 5in method 200, a position of the robotic system 20, such as the endeffector 44, relative to the subject 30 may be determined relative tothe image space. The two registrations may allow a third registration ordetermination of a position of the end effector determined with therobotic coordinate system to be made relative to the image space. It isfurther understood, however, that the robotic coordinate system of therobotic system 20 may be used to register to images of the subject 30,such as the image 108. As discussed above, the fiducials 140 may be usedto register the robotic system to the subject 30. The images acquired ofthe fiducials during registration may be used to register the sameimages to images 108 which may also include the fiducials, such as thosedisclosed with the display 84. Image to image registration may includeregistration such as the registration discussed above and/or performedwith the Mazor X™ Robotic Guidance System.

The robotic coordinate system is registered to the navigation space inthe method 224, as discussed above. Accordingly, in the method 300 arecall of the robotic coordinate system registration may be made inblock 310. The recall of the robotic coordinate system registration inblock 310 may be a recall from a memory system, such as an intransitorymemory system including any appropriate memory system. Further, theregistration of the robotic coordinate system to the navigation spacemay be performed in substantially any appropriate time, such as during aselected procedure. Generally, the navigation system 26 may bepositioned relative to the subject 30 for performing a procedure.Accordingly, the navigation space may be determined relative to thelocalizer, such as the localizer 88, during a selected point in aprocedure and usually includes at least an area of interest of thesubject 30. Recalling the registration of the robotic coordinate systemto the navigation system in block 310 may be made to recall or allow fora determination of a position of the robotic system in the navigationspace.

A determination of a position of the end effector 44 may be made in therobotic coordinate system in block 314. The end effector 44 may be anyselected movable portion of the robotic system 20. It is understood,however, that any appropriate portion of the robotic system 20 may be amovable portion and the end effector 44 is merely exemplary. The endeffector 44 may be used for assisting performing selected procedures,such as a guide for guiding the positioning of an implant into thesubject 30, such as positioning a pedicle screw in the vertebrae 126.Further, as discussed above, the position of the end effector 44 may bedetermined in the robotic coordinate system with appropriate mechanismssuch as with the encoders or the like of the robotic system 20. Thus,the position of the end effector 44 may be determined in the roboticcoordinate system using the robotic system 20.

The determined position of the end effector 44 in the robotic coordinatesystem in block 314 may be translated to the navigation space bytranslating the determined position of the end effector 44 with therecalled registration from block 310 and block 318. The translation ofthe position of the end effector in the robotic coordinate system to thenavigation coordinate system may be based upon the registration recalledin block 310 due to the robotic coordinate system to navigation spaceregistration in the method 224.

Generally the translation may be used to determine the position of theend effector 44 in the navigation space without the navigation system 26directly tracking the end effector 44 with the navigation system 26,such as with the localizer 88. Due to the tracked location of the endeffector 44 with the robotic system 20 with the robotic coordinatesystem, the determined position of the end effector 44 may be determinedin the navigation space due to the registration of the roboticcoordinate system to the navigation coordinate system in the method 224.The translation of the robotic coordinate system to the navigationcoordinate system may be made based upon the registration, such ascorrelating or a translation between the position (e.g. includingthree-dimensional location and orientation) of the end effector 44 andthe robotic coordinate system to the position in the navigationcoordinate system. The translation may be a mathematical translation orother appropriate translation due to the registration described above inblock 224.

Once a translation is determined of the end effector 44 from the roboticcoordinate system to the navigation space in block 318, an optionalstoring of the translated position of the end effector may be made inblock 322. The saving of the translated position of the end effector inblock 322 may be used for storing the translated position of the endeffector 44 for various purposes, such as for portions of a procedure.As discussed above, the robotic system 20 may be used to guide aposition of an implant into the subject 30, such as positioning apedicle screw into the vertebrae 126. The positioning of the pediclescrew into the vertebrae 126 may be performed without the navigationsystem 26. However, the position of the robotic system 20 may beregistered to the navigation system at any appropriate time, such asbefore placing the end effector 44 for guiding a pedicle screw. Thus,once the position of the end effector 44 is determined for performing aselected portion of a procedure, the translated position of the endeffector may be made to the navigation coordinate system 26 due to therobotic coordinate system to navigation space registration in block 224.Thus, saving the translated position of the end effector in block 322may be optional depending upon the timing of the registration of therobotic coordinate system to the navigation space in the method 224.Similarly, the saved position of the end effector and robotic coordinatesystem in block 316 may be optional as the position of the end effector44 may be saved at any appropriate time and may be used to be translatedto the navigation system space in block 318.

Once the translated determined/shape position of the end effector ismade in block 318, a recall of the image space to patientspace/navigation space from method 204 may be made in block 330. Theimage space to patient/navigation space registration in the method 204,as discussed above, translates the position of the navigation space tothe image space. Thus, a position in the navigation space may beillustrated relative to the image 108. For example, as discussed above,in FIG. 1 , the instrument may be illustrated as the icon 68 i relativeto the image 108, such as superimposed thereon, with the display device84. Recalling of the image space to the patient space registration fromblock 204 may assist in determining a position of the robotic coordinatesystem relative to the navigation system. In particular, as discussedabove, once the robotic coordinate system is registered to thenavigation system, a position of the end effector 44 may be madedetermined in the navigation space. As the navigation space isregistered to the image space in the method 204, a position of the endeffector 44 may be determined relative to the image 108, even if thenavigation system 26 is not directly navigating the end effector 44.Thus, recalling the image space to the patient space/navigation spaceregistration method 204 in block 330 may be used to determine a positionof the end effector relative to the image in block 334.

The determined position of the end effector 44 relative to the image inblock 334 may be used to display a graphical representation 45 i of amember 45 and or the end effector 44 relative to the image in block 346.The representation 45 i may be of the end effector may be a directrepresentation of the end effector 44, a representation of an implantpositioned with the end effector 44, or other appropriaterepresentation. Regardless the determined position of the end effectorrelative to the image in block 334 may be displayed in block 346 as arepresentation, such as an icon or other appropriate graphicalrepresentation 45 i as illustrated in FIG. 1 . This allows that even ifthe end effector 44 is not directly navigated or tracked with thenavigation system 26, the appropriate registrations and translations, asdiscussed above including in the method 300, may be used to illustrate arepresentation of a portion positioned with or relative to the endeffector 44 on the image 108. This may allow the user 72, or anyappropriate individual, to view a representation of a portion positionedthrough the end effector 44 and/or the end effector 44 relative to thesubject 30 with the display 84 without directly navigating or trackingthe end effector 44 with the navigation system 26.

As discussed above, the robotic coordinate system may be registered tothe navigation space in the method 224 illustrated in FIG. 6 . Theposition of the robotic system may then be displayed on an image that isregistered to the navigation space according to the method 300 asillustrated in FIG. 7 . It is understood, however, that the roboticcoordinate system to the navigation space registration in method 224 mayalso be used to allow for a navigation space to be registered to therobotic coordinate system to allow for the illustration of a navigatedinstrument relative to the image 108, even if the navigation system isnot previously registered to the image, due to the registration of therobotic coordinate system to the image space in method 182. Accordingly,with continuing reference to FIGS. 4-7 and additional reference to FIG.8 a method 340 allows for registration of a navigation space to an imagespace and illustration of a tracked instrument, such as the instrument68, on the image 108 without first performing a direct image space tosubject space registration, such as the method 204.

Initially, a navigation space or coordinate system may be defined inblock 342. The definition or formation of a navigation space in block342 may include positioning a localizer relative to a selected area ofinterest, such as relative to the subject 30. The navigation space orcoordinate system may encompass an area of interest of the subject 30,including the vertebrae 126 and/or a portion of the robotic system 20.The navigation space 342 may be defined relative to a localizer, such asthe localizer 88, and/or a reference member such as the subjectreference device 58. As discussed above, the image space may beregistered to the navigation space in method 204. If the navigationspace or subject space is not registered to the image space in method204, however, the defined navigation space in block 342 may be used totrack the snapshot tracker 160 for registration of the roboticcoordinate system to the navigation space as discussed above in method224. Thus, the robotic space or coordinate system registration to thenavigation space may be performed or recalled in block 224′ and allowsfor determination of the navigation space relative to the roboticcoordinate system of the robotic system 20. As discussed above, thesnapshot tracker 160 is at a known position in the robotic coordinatesystem due to the robotic tracking system, as discussed above.Accordingly, the snapshot tracker may be tracked in the navigation spaceand be used to coordinate or register the navigation space to therobotic coordinate system.

A recall and/or performing a robotic coordinate system to image spaceregistration in method 182′ may then be performed in the method 340. Asdiscussed above the image space, such as of the image 108, may beregistered relative to the robotic system 20 using the robotic fiducialimages acquired in block 186. Therefore the image space may beregistered to the robotic coordinate system in the method 340 byperforming or recalling the registration in block 182′ according to themethod 182 discussed above.

With the registration of the robotic coordinate system to the navigationspace in block 224′ and the recall and/or performing of the roboticcoordinate system to the image space in block 182′, a registration ofthe navigation space to the image space may be performed in block 346based upon the robotic coordinates to navigation space registration inblock 224′ and the robotic system to image space in block 182′. Thus,the navigation space may be registered to the image space withoutperforming a registration directly in the navigation space to the imagespace as disclosed of in the method 204 in FIG. 5 .

A translation of the navigation space to the image space may then occurin block 347. The translation may be a determination of the positioncoordinates in the navigation space to the image space due to the priorregistrations in block 182′ and 224′. The translation may be performedby a processor system, such as the processor system 102, to determinethe relating coordinates between the navigation space and the imagespace.

Once the navigation space is registered to the image space in block 347the trackable member, such as the instrument 68 with the tracking device66, may be tracked in block 348. Tracking of the trackable member inblock 348 may be with the navigation system that defines the navigationspace in block 342. As discussed above, the navigation space defined bythe navigation system may not be registered directly to the image space,but due to the method 340 the navigation space may be registered to theimage space. Thus, a tracked member in block 348 may have arepresentation displayed in an appropriate location relative to theimage 108 in block 350. The display of the instrument 68 may include theicon 68 i, as illustrated in FIG. 1 . In other words, a display of arepresentation of the instrument in block 350 may be performed bytracking the instrument in the navigation space due to the registrationof the navigation space to the robotic coordinate system which has beenregistered to the image space, as discussed above.

As discussed above, the robotic system 20 may be used during a firstportion of a procedure when navigated instruments are not being used andremoved during a second portion of a procedure when navigatedinstruments are used. During the second portion of the procedure,however, the user 72 may select to illustrate a position of the endeffector 44 and/or an implant positioned with use of the end effector 44even when the end effector 44 is not directly navigated and/or presentin the second portion of the procedure. The translation of thedetermined position of the end effector 44 for the robotic coordinatesystem to the navigation coordinate system allows for the illustrationof a representation of the end effector 44 without directly navigatingand/or tracking the end effector 44.

With continuing reference to FIG. 2 and FIGS. 6 and 8 , and additionalreference to FIG. 9 , the robotic system 20 may be registered to thenavigation space as described above in the method 224. The roboticsystem 20 may be registered to the navigation space, however, with anaugmentable or dynamic or movable trackable snapshot tracking sensor.The dynamic snapshot tracker 360 may include a selected tracking portionor tracking member 364. In various embodiments, the tracking member 364may include a light reflector or light emitter that may be tracked withan optical localizer, such as the optical localizer 88. As discussedabove, the snapshot tracking device 160 may be positioned relative to anavigation space such as that localized with a localizer 88.

In various embodiments, in addition to or alternatively to the singlesnapshot tracker 160, that may be positioned at a single position, themovable snapshot tracking device 360 may be moved in a navigation spacefor registration. In various embodiments, the localizer 88 may be ableto define or track a tracking device in a navigation space, such as anexemplary navigation space 370. The navigation space 370 may be relativeto the subject 30 and/or any other appropriate portion, such as thetable 104. Generally, the navigation space 370 may be a volume that isin a room or area that may be tracked or having devices positionedtherein that may be tracked with a tracking system, including thelocalizer 88 of the navigation system 26.

The dynamic snapshot tracking device 360 may be positioned within thevolume 370 at any appropriate location such as at a first location 360i. As illustrated in FIG. 79 the dynamic snapshot tracking device 360may include a single trackable member 364. The single trackable member364 may be substantially small and allow for easy positioning in acrowded space or volume, such in a surgical operating room. For example,as illustrated in FIG. 1 , an operating theater may generally have animaging system, one or more users (e.g. surgeons, surgical nurses,technicians, etc . . . ), and other instruments for use during aprocedure. Accordingly, volume or space around the subject 30 may be ata premium and substantially tight. Therefore, including a large orobstructive snapshot tracking device may be inefficient for performingthe robotic system coordinate to navigation space or coordinateregistration according to the method 224.

As discussed above, the robotic system 20 includes a robotic coordinatesystem that may be able to determine the position of the end effector44. The dynamic snapshot tracking device 360 may be positioned in theend effector 44 and moved within the navigation volume 370. Asillustrated in FIG. 9 , the dynamic snapshot tracking device 360 may bepositioned at the first position 360 i. The navigation system 26including the localizer 88 may track the dynamic snapshot trackingdevice 360 including the single trackable member 364 within thenavigation volume 370. The robotic system 20 may then move the dynamicsnapshot tracking device 360 to other locations or positions within thenavigation volume 370. For example, the robotic system 20 may move thedynamic snapshot tracking device 360 to a second position 360 ii, athird position 360 iii, and a fourth position 360 iv. The dynamicsnapshot tracking device 360 may be tracked at each of the fourpositions within the navigation volume 370. It is understood, however,that the dynamic snapshot tracking device 360 may also be moved to moreor less than four positions within the navigation space 370. Regardless,the dynamic snapshot tracking device 360 may be tracked at a pluralityof positions within the navigation volume, such as with the localizer88.

By tracking the dynamic snapshot tracking device 360 at a plurality ofpositions within the navigation volume 370, a larger volume may beassociated with positions of the dynamic snapshot tracking device 360within the navigation space 370 rather than only positioning the dynamicsnapshot tracking device 360 at a single location or position within thenavigation volume 370. The exemplary four positions 360 i-360 iv may beused in concert to define a virtual snapshot tracking device that islarger than the single member, such as at the larger four point snapshottracking device within the navigation volume 370. The virtual snapshottracker may form or define an array of trackable positions larger thanthe tracking device 160. The larger area may lead to greater accuracy,less deviation, etc.

As the robotic system 20 is able to precisely position the dynamicsnapshot tracking device 360 at the four positions within the navigationspace 370 (or any appropriate number of positions within the navigationspace 370), the snapshot tracking device may define a virtual snapshottracking device that may include or define a larger volume within thenavigation space 370. As the localizer 88 is used to track the dynamictracking device 360 at each of the positions within the navigation space370, the position of the robotic system 20, including the end effector44 within the navigation space 370, may be more precisely determined.For example, a larger tracking device that fills more of the navigationvolume 370 may be able to more precisely or accurately position ordetermine the position of the end effector 44 within the navigationspace 370. As discussed above and with reference to the method 224, thevirtual snapshot tracking device, including a plurality of positions ofthe snapshot tracking device 360, may then be used to register therobotic coordinate system to the navigation space coordinate system. Theregistration may be made based upon the known robotic coordinates of theend effector 44 at each position 360 i-360 iv and the tracked positionat each position 360 i-360 iv in the navigation space. As illustrated inFIG. 9 , rather than a single position of the snapshot tracking device360 a plurality of positions may be used for the registration. Theplurality of positions of the snapshot tracking device 360, however, maybe coordinated to a single large snapshot tracking device that is avirtual snapshot tracking device that incorporates all of the trackedpositions of the snapshot tracking device 360 within the volume 370 asexemplary illustrated as the positions 360 i-360 iv.

The foregoing description of the embodiments has been provided forpurposes of illustration and description. It is not intended to beexhaustive or to limit the invention. Individual elements or features ofa particular embodiment are generally not limited to that particularembodiment, but, where applicable, are interchangeable and can be usedin a selected embodiment, even if not specifically shown or described.The same may also be varied in many ways. Such variations are not to beregarded as a departure from the invention, and all such modificationsare intended to be included within the scope of the invention.

It should be understood that various aspects disclosed herein may becombined in different combinations than the combinations specificallypresented in the description and accompanying drawings. It should alsobe understood that, depending on the example, certain acts or events ofany of the processes or methods described herein may be performed in adifferent sequence, may be added, merged, or left out altogether (e.g.,all described acts or events may not be necessary to carry out thetechniques). In addition, while certain aspects of this disclosure aredescribed as being performed by a single module or unit for purposes ofclarity, it should be understood that the techniques of this disclosuremay be performed by a combination of units or modules associated with,for example, a medical device.

In one or more examples, the described techniques may be implemented inhardware, software, firmware, or any combination thereof. If implementedin software, the functions may be stored as one or more instructions orcode on a computer-readable medium and executed by a hardware-basedprocessing unit. Computer-readable media may include non-transitorycomputer-readable media, which corresponds to a tangible medium such asdata storage media (e.g., RAM, ROM, EEPROM, flash memory, or any othermedium that can be used to store desired program code in the form ofinstructions or data structures and that can be accessed by a computer).

Instructions may be executed by one or more processors, such as one ormore digital signal processors (DSPs), general purpose microprocessors,application specific integrated circuits (ASICs), field programmablelogic arrays (FPGAs), or other equivalent integrated or discrete logiccircuitry. Accordingly, the term “processor” as used herein may refer toany of the foregoing structure or any other physical structure suitablefor implementation of the described techniques. Also, the techniquescould be fully implemented in one or more circuits or logic elements.

What is claimed is:
 1. A method for registering a robotic coordinatesystem defined by a robotic system and a navigation coordinate systemdefined by a tracking system localizer, comprising: removably fixing afixed portion of a robotic system in a first position; determining arobotic coordinate system relative to the fixed portion of the roboticsystem with a robotic tracking system; creating a navigation spacehaving a navigation coordinate system with a tracking system having thetracking system localizer relative to the fixed portion of the roboticsystem; connecting a reference marker trackable with the tracking systemrelative to the fixed portion of the robotic system; moving a trackablemarker with a moveable portion of the robotic system within thenavigation coordinate system; tracking the reference marker and thetrackable marker in the navigation coordinate system with the trackingsystem; and determining a registration between the robotic coordinatesystem and the navigation coordinate system based at least on thetracked reference marker and the trackable marker.
 2. The method ofclaim 1, further comprising: registering the robotic coordinate systemto a subject; wherein a moveable portion of the robotic system istracked with the robotic tracking system in the robotic coordinatesystem due at least to movement of the robotic system.
 3. The method ofclaim 2, wherein the registering the robotic coordinate system to thesubject, comprises: positioning the subject relative to the firstposition; and acquiring an image of a robotic fiducial fixed relative tothe fixed portion of the robotic system and the subject.
 4. The methodof claim 2, further comprising: registering the robotic coordinatesystem to an image space; registering the navigation space to the imagespace via the determined registration between the robotic coordinatesystem and the navigation coordinate system; tracking an instrumentwithin the navigation space with the tracking system; and displaying agraphical representation relative to an image based on the registrationand the tracking the instrument.
 5. The method of claim 4, furthercomprising: performing at least a first portion of a procedure with amovable portion the robotic system; determining a position of themovable portion of the robotic system in the navigation space based onthe determined registration between the robotic coordinate system andthe navigation coordinate system; and displaying a graphicalrepresentation of at least a member positioned with the movable portionrelative to the image.
 6. The method of claim 5, wherein the firstportion occurs at a first time and the displaying the graphicalrepresentation of at least the member positioned with the movableportion occurs at a second time after the first time.
 7. The method ofclaim 6, further comprising: removing the robotic system from near thenavigation space after the first time and before the second time.
 8. Themethod of claim 7, further comprising: positioning the member within thesubject guided with the movable portion; determining a position of themember within the subject based on the robotic coordinate system; andwherein displaying the graphical representation of at least the memberis based on positioning the member with the movable portion.